Significant increase in factual knowledge with web-assisted problem-based learning as part of an undergraduate cardio-respiratory curriculum

In recent years, increasing attention has been paid to web-based learning although the advantages of computer-aided instruction over traditional teaching formats still need to be confirmed. This study examined whether participation in an online module on the differential diagnosis of dyspnoea impacts on student performance in a multiple choice examination of factual knowledge in cardiology and pneumology. A virtual problem-based learning environment for medical students supervised by postgraduate teachers was created. Seventy-four out of 183 fourth-year medical students volunteered to use the online module while attending a 6-week cardio-respiratory curriculum in summer 2007. Of these, 40 were randomly selected to be included (intervention group); the remaining 34 served as an internal control group. Analysis of all written exams taken during the preceding term showed that both groups were comparable (86.4 ± 1.1 vs. 85.9 ± 1.1%; p = 0.751). Students in the intervention group scored significantly higher in the final course assessment than students allocated to the control group (84.8 ± 1.3 vs. 79.5 ± 1.4%; p = 0.006; effect size 0.67). Thus, additional problem-based learning with an online module as part of an undergraduate cardio-respiratory curriculum lead to higher students’ scores in an exam testing factual knowledge. Whether using this teaching format increases overall student motivation to engage in the learning process needs to be further investigated

How can we improve teaching of ECG interpretation skills? Findings from a prospective randomised trial.

BACKGROUND: There is an ongoing debate on how ECG interpretation should be taught during undergraduate medical training. This study addressed the impact of teaching format, examination consequences and student motivation on skills retention. METHODS: A total of 493 fourth-year medical students participated in a six-group, partially randomised trial. Students received three levels of teaching intensity: self-directed learning (2 groups), lectures (2 groups) or small-group peer-teaching (2 groups). On each level of teaching intensity, end-of-course written examinations (ECG exit exam) were summative in one group and formative in the other. Learning outcome was assessed in a retention test two months later. RESULTS: Retention test scores were predicted by summative assessments (adjusted beta 4.08; 95% CI 1.39-6.78) but not by the type of teaching. Overall performance levels and motivation did not predict performance decrease or skills retention. CONCLUSIONS: Summative assessments increase medium-term retention of ECG interpretation skills, irrespective of instructional format

Potential explanations for conflicting findings on abrupt versus gradual smoking cessation: a population study in England

BACKGROUND AND AIM: Observational and trial evidence conflict on the efficacy of two contrasting behavioural approaches to quitting smoking – gradual and abrupt. Observational data suggests an abrupt approach to quitting is superior to a gradual approach, whilst trials show no difference. One potential explanation is self-selection in observational data, whereby people can choose their quit approach and those who find it harder to quit may be more likely to choose a gradual quit approach. This study aims to investigate potential explanations for these conflicting findings. METHODS: We used observational data from a nationally representative sample of adults in England from November 2006 to February 2020 who reported smoking and had made at least one quit attempt in the past year (n=21,542). We used logistic regression models to assess the association between abrupt versus gradual quit attempts and quit success, adjusting for sociodemographic, smoking and quit attempt characteristics. FINDINGS: Abrupt, versus gradual, attempts were associated with improved quit success in an unadjusted model (OR=2.02, 95% CI=1.86-2.19). This association remained after adjusting for a broad range of relevant confounders (OR=1.75, 95% CI=1.59-1.93). CONCLUSIONS: Among a representative sample of adults who had smoked and made a quit attempt in the past year, there was evidence of an association between abrupt attempts and quit success before and after adjusting for relevant confounders. This suggests that the differences in quit success seen between abrupt and gradual quit attempt types are not completely driven by self-selection in observational data. IMPLICATIONS: We investigated explanations for conflicting findings on the efficacy of gradual versus abrupt approaches to quitting smoking between trial and observational data. Despite adjusting observational data for sociodemographic, smoking and quit attempt characteristics, an association between abrupt quitting and quit success remained. Therefore, differences in quit success were not completely driven by self-selection of a gradual approach by people who found it especially difficult to quit or differences in the use of quitting aids. However, characteristics adjusted for were limited by the data available, and future research should continue to investigate the difference in findings across study types to inform cessation support

Decrease in resting heart rate measured using smartphone apps to verify abstinence from smoking: an exploratory study

INTRODUCTION: Verifying self-reports of smoking abstinence is challenging in studies that involve remote data collection. Resting heart rate (HR) decreases during smoking abstinence. This study assessed whether a decrease in resting HR measured using freely available smartphone apps could potentially be used to verify smoking abstinence. METHODS: This study involved a repeated measures experimental design, with data collection in natural setting. Participants were 18 adult, daily smokers. They recorded resting HR in beats per minute (bpm) using freely available smartphone apps during five time points (two in the morning and three post-noon) on each of three days. The outcome measure was the mean of the post-noon HR recordings. The experimental condition for each of the three days (counterbalanced order) was: 1) smoking as usual, 2) not smoking without nicotine replacement therapy (NRT), or 3) not smoking but using NRT. Abstinence was verified using expired-air carbon monoxide (CO) concentration. RESULTS: Compared with the smoking as usual condition, mean HR was 13.4 bpm lower (95%CI=5.4-21.4,p=0.001) in the not smoking without NRT condition and 10.4 bpm lower (95%CI=3.1-17.8, p=0.004) in the not smoking with NRT condition. There was no statistically significant difference in HR between the two not smoking conditions (p=0.39). Abstinence during not smoking days without and with NRT was CO-verified in 18/18 and in 16/18 cases, respectively. CONCLUSIONS: Self-recording of resting heart rate in natural setting using smartphone apps shows a reliable decrease in response to smoking abstinence and may provide a basis for remote verification in smoking cessation studies. IMPLICATIONS: Remote verification of self-reported abstinence in smoking cessation studies remains challenging. Smoking abstinence has been shown to decrease resting heart rate under laboratory conditions. This study demonstrated that self-recording using freely available smartphone apps shows reliable decreases in resting heart rate during smoking abstinence and may provide a basis for inexpensive remote verification of smoking abstinence

Structured Smoking Cessation Training for Medical Students: a prospective study

Introduction: Physician adherence to guideline recommendations regarding the provision of counseling and support for smokers willing to quit is low. A lack of training during undergraduate medical education has been identified as a potential cause. This prospective intervention study evaluated a novel teaching module for medical students. Methods: As part of a 6-week cardiovascular course, 125 fourth-year undergraduate medical students received a multimodal and interactive teaching module on smoking cessation, including online learning material, lectures, seminars, and practical skills training. Short- and medium-term effects on knowledge, skills, attitudes, and self-reported practice were measured using written examinations and an objective structured clinical examination at the end of the module and 6 months later. Results were compared to data obtained from a historical control cohort (n = 70) unexposed to the intervention. Results: At the 6-month follow-up, scores in the knowledge test were significantly higher in the intervention than the control group (61.1% vs. 51.7%; p < .001). A similar pattern was observed in the objective structured clinical examination (71.5% vs. 60.5%; p < .001). More students in the intervention than control group agreed that smoking was a chronic disease (83.1% vs. 68.1%; p = .045). The control group was more likely to report recording smoking status (p = .018), but no group difference was detected regarding the report of advising to quit (p = .154). Conclusions: A novel teaching module for undergraduate medical students produced a sustained learning outcome in terms of knowledge, skills, and attitudes but not self-reported practice. Implications: Studies across the world have identified considerable knowledge gaps and deficits in practical training with regard to smoking cessation counseling in undergraduate medical students. This paper describes a teaching intervention informed by current recommendations for the design of educational activities aimed at enabling medical students to deliver adequate behavior change counseling. The teaching module was tailored to the needs of a specific healthcare system. Given its effectiveness as demonstrated in this prospective study, a rollout of this intervention in medical schools might have the potential to substantially improve medical students’ knowledge, skills, and attitudes in relation to smoking cessation counseling

Moving Knowledge Acquisition From the Lecture Hall to the Student Home: A Prospective Intervention Study.

BACKGROUND: Podcasts are popular with medical students, but the impact of podcast use on learning outcomes in undergraduate medical education has not been studied in detail. OBJECTIVE: Our aim was to assess the impact of podcasts accompanied by quiz questions and lecture attendance on short- and medium-term knowledge retention. METHODS: Students enrolled for a cardio-respiratory teaching module were asked to prepare for 10 specific lectures by watching podcasts and submitting answers to related quiz questions before attending live lectures. Performance on the same questions was assessed in a surprise test and a retention test. RESULTS: Watching podcasts and submitting answers to quiz questions (versus no podcast/quiz use) was associated with significantly better test performance in all items in the surprise test and 7 items in the retention test. Lecture attendance (versus no attendance) was associated with higher test performance in 3 items and 1 item, respectively. In a linear regression analysis adjusted for age, gender, and overall performance levels, both podcast/quiz use and lecture attendance were significant predictors of student performance. However, the variance explained by podcast/quiz use was greater than the variance explained by lecture attendance in the surprise test (38.7% vs. 2.2%) and retention test (19.1% vs. 4.0%). CONCLUSIONS: When used in conjunction with quiz questions, podcasts have the potential to foster knowledge acquisition and retention over and above the effect of live lectures

Condensation of Pairs of Fermionic Atoms Near a Feshbach Resonance

We have observed Bose-Einstein condensation of pairs of fermionic atoms in an ultracold ^6Li gas at magnetic fields above a Feshbach resonance, where no stable ^6Li_2 molecules would exist in vacuum. We accurately determined the position of the resonance to be 822+-3 G. Molecular Bose-Einstein condensates were detected after a fast magnetic field ramp, which transferred pairs of atoms at close distances into bound molecules. Condensate fractions as high as 80% were obtained. The large condensate fractions are interpreted in terms of pre-existing molecules which are quasi-stable even above the two-body Feshbach resonance due to the presence of the degenerate Fermi gas.Comment: submitted to PRL. v3: clarifying revisions, added referenc

Основні закономірності зародження і росту втомних тріщин в алюмінієвих пластинах із зміцненими отворами

The method of modeling stress-strain state for holes burnishing using FEM has been analyzed. A series of fatigue tests were carried out using plates containing plain holes and cold expanded holes in aluminium For various diameters of holes and cold expansion degree there exists a certain correlation between the stress range or maximum stress on the edge of hole on the entrance face of plate and lifetime of fatigue crack initiation

Structured smoking cessation training for health professionals on cardiology wards: a prospective study.

Background: Smoking is a major cardiovascular risk factor, and smoking cessation is imperative for patients hospitalised with a cardiovascular event. This study aimed to evaluate a systems-based approach to helping hospitalised smokers quit and to identify implementation barriers. Design: Prospective intervention study followed by qualitative analysis of staff interviews Methods: The prospective intervention study assessed the effects of implementing standard operating procedures (SOPs) for the provision of counselling and pharmacotherapy to smokers admitted to cardiology wards on counselling frequency. In addition, a qualitative analysis of staff interviews was undertaken to examine determinants of physician and nurse behaviour; this sought to understand barriers in terms of motivation, capability and/or opportunity. Results: A total of 150 smoking patients were included in the study (75 before and 75 after SOP implementation). Before the implementation of SOPs, the proportion of patients reporting to have received cessation counselling from physicians and nurses was 6.7% and 1.3%, respectively. Following SOP implementation, these proportions increased to 38.7% (p < 0.001) and 2.7% (p = 0.56), respectively. Qualitative analysis revealed that lack of motivation, e.g. role incongruence, appeared to be a major barrier. Conclusions: Introduction of a set of standard operating procedures for smoking cessation advice was effective with physicians but not nurses. Analysis of barriers to implementation highlighted lack of motivation rather than capability or opportunity as a major factor that would need to be addressed

Assembling and auditing a comprehensive DNA barcode reference library for European marine fishes

A large-scale comprehensive reference library of DNA barcodes for European marine fishes was assembled, allowing the evaluation of taxonomic uncertainties and species genetic diversity that were otherwise hidden in geographically restricted studies. A total of 4118 DNA barcodes were assigned to 358 species generating 366 Barcode Index Numbers (BIN). Initial examination revealed as much as 141 BIN discordances (more than one species in each BIN). After implementing an auditing and five-grade (A-E) annotation protocol, the number of discordant species BINs was reduced to 44 (13% grade E), while concordant species BINs amounted to 271 (78% grades A and B) and 14 other had insufficient data (grade D). Fifteen species displayed comparatively high intraspecific divergences ranging from 2·6 to 18·5% (grade C), which is biologically paramount information to be considered in fish species monitoring and stock assessment. On balance, this compilation contributed to the detection of 59 European fish species probably in need of taxonomic clarification or re-evaluation. The generalized implementation of an auditing and annotation protocol for reference libraries of DNA barcodes is recommended.info:eu-repo/semantics/publishedVersio